title: Image-guided surgical navigation for removal of foreign bodies in the deep maxillofacial region.
abstract: OBJECTIVE
  Most trauma surgeons encounter numerous penetrating injuries. Some foreign bodies can cause pain, infection, and discomfort to the patient. Serious functional disorders also are likely to occur. Foreign bodies in critical areas must be removed. This report describes the use of image-guided technology for the removal of foreign bodies deep in the maxillofacial region.
  
  
  METHODS
  From 2008 through 2011, 5 patients with foreign bodies in the maxillofacial area underwent image-guided removal at the authors' department. The STN navigation system (Stryker-Leibinger, Freiburg, Germany) was used for surgical planning and intraoperative navigation. Preoperatively, computerized tomography and digital subtraction angiography were used to create 3-dimensional views of the region to aid surgeons in more accurately defining the spatial location of the foreign object. During surgery, the foreign objects and surgical instruments were visualized on the screen.
  
  
  RESULTS
  In all 5 cases, the foreign bodies were removed by minimally invasive access without any complications. Surgical time was approximately 40% shorter compared with the conventional technique of not using image-guided navigation. A 1-year postoperative evaluation showed that the patients' complaints and symptoms had resolved, function was restored, and esthetics were remarkably improved.
  
  
  CONCLUSIONS
  Navigation-guided removal of foreign bodies in the complex, deep maxillofacial region in proximity to vital areas can be regarded an ideal and valuable option for these potentially complicated procedures.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Haijun
authors.initials: H
authors.lastname: Gui
authors.forename: Huawei
authors.initials: H
authors.lastname: Yang
authors.forename: Steve G F
authors.initials: SG
authors.lastname: Shen
authors.forename: Bing
authors.initials: B
authors.lastname: Xu
authors.forename: Shilei
authors.initials: S
authors.lastname: Zhang
authors.forename: Joy S
authors.initials: JS
authors.lastname: Bautista
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction / Q000379:methods; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007430:Intraoperative Care; D008297:Male; D008406:Masseter Muscle / Q000293:injuries; D008446:Maxillofacial Injuries / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D009915:Orbit / Q000293:injuries; D010347:Patient Care Planning; D010614:Pharynx / Q000293:injuries; D020127:Recovery of Function / Q000502:physiology; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D013701:Temporal Bone / Q000293:injuries; D036542:Tomography, Spiral Computed / Q000379:methods; D014950:Wounds, Penetrating / Q000601:surgery*; D055815:Young Adult